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https://www.readbyqxmd.com/read/28453712/use-of-performance-metrics-for-the-measurement-of-universal-coverage-for-maternal-care-in-mexico
#1
Edson Serván-Mori, David Contreras-Loya, Octavio Gomez-Dantés, Gustavo Nigenda, Sandra G Sosa-Rubí, Rafael Lozano
This study provides evidence for those working in the maternal health metrics and health system performance fields, as well as those interested in achieving universal and effective health care coverage. Based on the perspective of continuity of health care and applying quasi-experimental methods to analyse the cross-sectional 2009 National Demographic Dynamics Survey (n = 14 414 women), we estimated the middle-term effects of Mexico's new public health insurance scheme, Seguro Popular de Salud (SPS) (vs women without health insurance) on seven indicators related to maternal health care (according to official guidelines): (a) access to skilled antenatal care (ANC); (b) timely ANC; (c) frequent ANC; (d) adequate content of ANC; (e) institutional delivery; (f) postnatal consultation and (g) access to standardized comprehensive antenatal and postnatal care (or the intersection of the seven process indicators)...
June 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28448109/how-medicaid-enrollees-fare-compared-with-privately-insured-and-uninsured-adults-findings-from-the-commonwealth-fund-biennial-health-insurance-survey-2016
#2
Munira Z Gunja, Sara R Collins, David Blumenthal, Michelle M Doty, Sophie Beutel
ISSUE: The number of Americans insured by Medicaid has climbed to more than 70 million, with an estimated 12 million gaining coverage under the Affordable Care Act’s Medicaid expansion. Still, some policymakers have questioned whether Medicaid coverage actually improves access to care, quality of care, or financial protection. GOALS: To compare the experiences of working-age adults who were either: covered all year by private employer or individual insurance; covered by Medicaid for the full year; or uninsured for some time during the year...
April 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28445624/the-role-of-publicly-funded-family-planning-sites-in-health-insurance-enrollment
#3
Jennifer Yarger, Sara Daniel, M Antonia Biggs, Jan Malvin, Claire D Brindis
CONTEXT: Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment. METHODS: In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance...
April 26, 2017: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/28445591/screening-endoscopy-finds-high-prevalence-of-helicobacter-pylori-and-intestinal-metaplasia-in-korean-american-with-limited-access-to-health-care
#4
Yanghee Woo, Carolyn E Behrendt, Garrick Trapp, Jae Geun Hyun, Tamas Gonda, Yuman Fong, Timothy Wang
BACKGROUND: Gastric cancer (GC) is the leading cause of cancer death among Korean Americans. Prevention and early detection is improved by screening. METHODS: Between September 2013 and March 2015, ethnic Koreans age 40 or older without history or symptoms of GC and without upper endoscopy (UE) during previous 3 years were enrolled. Participants were offered screening with GC risk assessment followed by UE with biopsies. RESULTS: Risk assessment was provided to 146 participants (age 55...
April 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28445217/why-health-insurance-matters-and-why-research-evidence-should-too
#5
Benjamin D Sommers
In the current debate over the future of the Affordable Care Act (ACA), research evidence on the impact of the law and the effects of health insurance coverage in general is critical. Studies of health insurance expansion over the past decade have demonstrated that coverage expansions can produce significant reductions in mortality-particularly among minorities, those living in poorer areas, and those with chronic conditions potentially treatable with timely medical care. More recent studies of the ACA in particular demonstrate that the law has produced historically large reductions in the uninsured rate, with resulting improvements in access to care, perceived quality of care, and self-reported health...
April 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28444483/exploring-racial-gender-and-insurance-disparities-in-patients-with-osteoporotic-fractures
#6
Sarah C DeShields, Cynthia C Romero, Tina D Cunningham
The objective of this study is to examine racial, gender, and insurance disparities in hospital outcomes among patients diagnosed with osteoporotic fractures aged 55 years and older. A total of 36,153 patients were included in this study. The sample was constructed from de-identified patient-level data for 2011 through 2014 from the Virginia Health Information (VHI) inpatient discharge database. Differences in mortality and 30-day readmission across race, gender, and insurance status were examined using logistic regression and generalized linear models for hospital charges and length of stay...
April 25, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28439903/did-health-care-reform-help-kentucky-address-disparities-in-coverage-and-access-to-care-among-the-poor
#7
Joseph A Benitez, E Kathleen Adams, Eric E Seiber
OBJECTIVE: To evaluate the impact of Kentucky's full rollout of the Affordable Care Act on disparities in access to care due to poverty. DATA SOURCE: Restricted version of the Behavioral Risk Factor Surveillance System (BRFSS) for Kentucky and years 2011-2015. STUDY DESIGN: We use a difference-in-differences framework to compare trends before and after implementation of the Affordable Care Act (ACA) in health insurance coverage, several access measures, and health care utilization for residents in higher versus lower poverty ZIP codes...
April 25, 2017: Health Services Research
https://www.readbyqxmd.com/read/28435485/impact-of-health-policy-changes-on-emergency-medicine-in-maryland-stratified-by-socioeconomic-status
#8
Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barrueto, Jon M Hirshon
INTRODUCTION: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD's Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433333/effects-of-hospital-safety-net-burden-and-hospital-volume-on-failure-to-rescue-after-open-abdominal-aortic-surgery
#9
Eric B Rosero, Girish P Joshi, Abu Minhajuddin, Carlos H Timaran, J Gregory Modrall
OBJECTIVE: Failure to rescue (FTR) is defined as the inability to rescue a patient from major perioperative complications, resulting in operative mortality. FTR is a known contributor to operative mortality after open abdominal aortic surgery. Understanding the causes of FTR is essential to designing interventions to improve perioperative outcomes. The objective of this study was to determine the relative contributions of hospital volume and safety-net burden (the proportion of uninsured and Medicaid-insured patients) to FTR...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#10
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28423460/individual-and-neighborhood-characteristics-of-children-seeking-emergency-department-care-for-firearm-injuries-within-the-pecarn-network
#11
Patrick M Carter, Lawrence J Cook, Michelle L Macy, Mark R Zonfrillo, Rachel M Stanley, James M Chamberlain, Joel A Fein, Elizabeth R Alpern, Rebecca Cunningham
OBJECTIVE: To describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network, and assess the influence of both individual and neighborhood factors on firearm-related injury risk. METHODS: This was a retrospective, multicenter cross-sectional analysis of children (<19-years-old) presenting to 16 pediatric EDs (2004-2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent. Neighborhood variables were derived from home address data...
April 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28423388/a-national-study-of-the-effect-of-race-socioeconomic-status-and-gender-on-burn-outcomes
#12
Hala Bedri, Kathleen S Romanowski, Junlin Liao, Ghassan Al-Ramahi, Jason Heard, Thomas Granchi, Lucy Wibbenmeyer
Age, burn size, and inhalation injury are the major contributing variables related to burn mortality. While the female gender has been linked to higher mortality, the impact of socioeconomic status has not been well studied. The interplay between these three factors is also unknown. This study sought to clarify the effects of these variables on outcomes in a national sample of patients with burns. A retrospective review of 172,640 patient records of the National Burn Repository (version 8, 2002-2011) data was conducted...
May 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28422923/a-cross-sectional-study-of-emergency-care-utilization-and-associated-costs-of-violent-related-assault-injuries-in-the-united-states
#13
Michael C Monuteaux, Eric W Fleegler, Lois K Lee
BACKGROUND: Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to: (1) estimate rates of violent-related injuries evaluated in United States EDs; (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010; and (3) to determine the associated healthcare and work-loss costs. METHODS: We examined adults 18 years of age and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28407650/insurance-coverage-and-utilization-at-a-sexually-transmitted-disease-clinic-in-a-medicaid-expansion-state
#14
Madeline C Montgomery, Julia Raifman, Amy S Nunn, Thomas Bertrand, A Ziggy Uvin, Theodore Marak, Jaime Comella, Alexi Almonte, Philip A Chan
BACKGROUND: In Rhode Island, the Patient Protection and Affordable Care Act has led to over 95% of the state's population being insured. We evaluated insurance coverage and barriers to insurance use among patients presenting for services at the Rhode Island sexually transmitted disease (STD) clinic. METHODS: We analyzed factors associated with insurance coverage and utilization among patients presenting for STD services between July and December 2015. RESULTS: A total of 692 patients had insurance information available; of those, 40% were uninsured...
May 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28407044/health-insurance-type-and-control-of-hypertension-among-us-women-living-with-and-without-hiv-infection-in-the-women-s-interagency-hiv-study
#15
Christina Ludema, Stephen R Cole, Joseph J Eron, G Mark Holmes, Kathryn Anastos, Jennifer Cocohoba, Marge H Cohen, Hannah L F Cooper, Elizabeth T Golub, Seble Kassaye, Deborah Konkle-Parker, Lisa Metsch, Joel Milam, Tracey E Wilson, Adaora A Adimora
BACKGROUND: Health care access is an important determinant of health. We assessed the effect of health insurance status and type on blood pressure control among US women living with (WLWH) and without HIV. METHODS: We used longitudinal cohort data from the Women's Interagency HIV Study (WIHS). WIHS participants were included at their first study visit since 2001 with incident uncontrolled blood pressure (BP) (i.e., BP ≥140/90 and at which BP at the prior visit was controlled (i...
April 12, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28404760/the-21-gene-recurrence-score-assay-for-node-positive-early-stage-breast-cancer-and-impact-of-rxponder-trial-on-chemotherapy-decision-making-have-clinicians-already-decided
#16
Jagar Jasem, Christine M Fisher, Arya Amini, Elena Shagisultanova, Rachel Rabinovitch, Virginia F Borges, Anthony Elias, Peter Kabos
Background: The 21-gene recurrence score (RS) assay is retrospectively validated for assessing prognosis and benefit from chemotherapy in hormone receptor-positive, early-stage breast cancer (EBC) with low RS. We hypothesized that oncologists have already incorporated the RS assay for decision-making in higher-risk, node-positive disease, despite the lack of prospective data and contrary to NCCN Guideline recommendations. This study provides the first analysis of trends and differences in RS use and therapeutic implications in a population-based data set of patients with node-positive EBC...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28402826/the-affordable-care-act-implications-for-health-care-equity
#17
REVIEW
Adam Gaffney, Danny McCormick
Inequalities in medical care are endemic in the USA. The Affordable Care Act (ACA), passed in 2010 and fully implemented in 2014, was intended to expand coverage and bring about a new era of health-care access. In this review, we evaluate the legislation's impact on health-care equity. We consider the law's coverage expansion, insurance market reforms, cost and affordability provisions, and delivery-system reforms. Although the ACA improved coverage and access-particularly for poorer Americans, women, and minorities-its overall impact was modest in comparison with the gaps present before the law's implementation...
April 8, 2017: Lancet
https://www.readbyqxmd.com/read/28402825/inequality-and-the-health-care-system-in-the-usa
#18
REVIEW
Samuel L Dickman, David U Himmelstein, Steffie Woolhandler
Widening economic inequality in the USA has been accompanied by increasing disparities in health outcomes. The life expectancy of the wealthiest Americans now exceeds that of the poorest by 10-15 years. This report, part of a Series on health and inequality in the USA, focuses on how the health-care system, which could reduce income-based disparities in health, instead often exacerbates them. Other articles in this Series address population health inequalities, and the health effects of racism, mass incarceration, and the Affordable Care Act (ACA)...
April 8, 2017: Lancet
https://www.readbyqxmd.com/read/28402420/the-effect-of-health-insurance-and-health-facility-upgrades-on-hospital-deliveries-in-rural-nigeria-a-controlled-interrupted-time-series-study
#19
Daniëlla Brals, Sunday A Aderibigbe, Ferdinand W Wit, Johannes C M van Ophem, Marijn van der List, Gordon K Osagbemi, Marleen E Hendriks, Tanimola M Akande, Michael Boele van Hensbroek, Constance Schultsz
Background : Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. Methods : We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities...
April 11, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28395014/low-value-medical-services-in-the-safety-net-population
#20
Michael L Barnett, Jeffrey A Linder, Cheryl R Clark, Benjamin D Sommers
Importance: National patterns of low-value and high-value care delivered to patients without insurance or with Medicaid could inform public policy but have not been previously examined. Objective: To measure rates of low-value care and high-value care received by patients without insurance or with Medicaid, compared with privately insured patients, and provided by safety-net physicians vs non-safety-net physicians. Design, Setting, and Participants: This multiyear cross-sectional observational study included all patients ages 18 to 64 years from the National Ambulatory Medical Care Survey (2005-2013) and the National Hospital Ambulatory Medical Care Survey (2005-2011) eligible for any of the 21 previously defined low-value or high-value care measures...
April 10, 2017: JAMA Internal Medicine
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